Presented a talk on Curbing Transplant Tourism and Organ Commercialisation at 19th Scientific Meeting of the Malaysia Society of Transplantation. Malaysia has implemented a few measures to curb such unethical practices which include policy to stop giving free immunosuppressive drugs to patients who underwent illegal overseas transplant through organ trading. Exploitation of the vulnarable groups in the society like the poor and executed prisoners violates the principles of medical ethics and irrespect human dignity. Number of unethical overseas transplant was oberved to have gone down over the years. ‪#‎dermaorgan‬

1. Curbing transplant tourism
and organ trafficking
Hirman Ismail MD MPH
Transplantation Unit, Medical Development Division
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

2. Objective
Main objective of this presentation is to create and
enhance awareness among healthcare professionals about
the need to fight organ trafficking and transplant tourism.
Malaysia Society of Transplantation is a signatory to the
Declaration of Istanbul on Organ Trafficking and
Transplant Tourism, 2008.
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

3. Content
! Introduction
! International effort
! Malaysia’s effort
! Conclusion
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

4. INTRODUCTION
Definition | Why this is happening? | Why we need to fight?
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

5. Definition
! Organ trafficking is the recruitment, transport, transfer,
harboring or receipt of living or deceased persons or their organs
by means of the threat or use of force or other forms of coercion,
of abduction, of fraud, of deception, of the abuse of power or of a
position of vulnerability, or of the giving to, or the receiving by, a
third party of payments or benefits to achieve the transfer of
control over the potential donor, for the purpose of exploitation
by the removal of organs for transplantation.
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

6. 19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

7. Definition (2)
! Transplant commercialism is a policy or practice in which an
organ is treated as a commodity, including by being bought or sold
or used for material gain.
! Travel for transplantation is the movement of organs, donors,
recipients or transplant professionals across jurisdictional borders
for transplantation purposes. Travel for transplantation becomes
transplant tourism if it involves organ trafficking and/or
transplant commercialism or if the resources (organs, professionals
and transplant centers) devoted to providing transplants to
patients from outside a country undermine the country's ability to
provide transplant services for its own population.
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

8. 19th Scientific Meeting of Malaysian Society of
Transplantation, 27-28 May 2016, Penang

9. Why we need to fight?
! Unethical – against non-maleficence (do no harm),
inequity, inequality, injustice, no respect for human
dignity
! Illegal in many countries
! Promotes crime
! Against the Fatwa / Islamic teachings
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

10. International Effort
WHO | The Transplantation Society & other international bodies
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

11. WHO
! Guiding Principles on Human Cell, Tissue and Organ
Transplantation – WHA Resolution 2010
! Content : Consent, Independent determination death,
Deceased donation is preferred, Removal not from
minors, No trading, Promotion / advertising,
Professional involvements in trading or coercion,
Justifiable professional fees, Just allocation criteria,
Safety, efficacy and quality & Transparency and open
to scrutiny
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

12. 19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

13. 19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

14. Global agenda
! The UN Protocol to Prevent, Suppress and Punish
Trafficking in Persons
! Optional Protocol on the sale of children, child
prostitution and child pornography (2000) to the UN
Convention on the Rights of the Child (1989)
! An Additional Protocol to the European Convention
on Human Rights and Biomedicine Concerning
Transplantation of Organs and Tissues of Human
Origin (2002)
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

15. Global Agenda
! Council of Europe Convention against Trafficking in
Human Organs (Adopted by the Committee of
Ministers on 9 July 2014 at the 1205th meeting of the
Ministers’ Deputies)
! The Declaration of Istanbul on Organ Trafficking and
Transplant Tourism (TTS and ISN, 2008)
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

16. Malaysia’s effort
National Policy | IS Policy | UTAC | New law
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

17. 19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

18. 19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

21. 19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

22. 19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

23. 19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

24. Conclusion
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

25. Conclusion
! Is a real threat
! Prevention and promoting self sufficiency is the way
forward – education, education, education
! Public, patients and family members shall be made
aware about organ commercialism
! Legislation to safeguard ethical practices
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang

26. 0
20
40
60
80
100
120
140
160
180
200
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
No. of Kidney Transplant Recipients in Malaysia,
performed locally (public & private institutions) vs.
overseas, 2005 - 2014
Total Overseas Local
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang
Source: 22nd Report of the Malaysian Dialysis and Transplantation Registry 2014

27. 0
20
40
60
80
100
120
140
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
No. of Kidney Transplant Recipients in Malaysia,
performed locally (live donor & cadaveric) vs. overseas,
2005 - 2014
Overseas (commercial) Local (live donors) Local (cadaveric)
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang
Source: 22nd Report of the Malaysian Dialysis and Transplantation Registry 2014

28. Thank you
hirman@moh.gov.my | Twitter @DrHirman #MedTweetMy |
www.about.me/hirmanismail
19th Scientific Meeting of Malaysian Society of Transplantation, 27-28 May 2016, Penang